Organization Active NPI

Mark C Engasser M D P a

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Edina, MN
National Provider Identifier
1881815322
Registry record updated Jan 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
22841 Issued in MN
Legal business name
MARK C ENGASSER M D P A
Practice address
6600 France Ave S
Suite 615
Edina, MN 55435-1807
Phone
(952) 920-4333
Fax
(952) 920-6338
NPI assigned
May 1, 2007
Last updated
Jan 27, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mark Charles Engasser, M.D.NPI 1417911884
Title
Owner
Phone
(952) 920-4333

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Orthopaedic Surgery) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207XX0005X 22841 MN Primary

Addresses

Primary practice location

6600 France Ave S
Suite 615
Edina, MN 55435-1807

Mailing address

6600 France Ave S
Suite 615
Edina, MN 55435-1807
Phone (952) 920-4333

Other identifiers 1

IdentifierTypeStateIssuer
856500700MedicaidMN

National Provider Directory

National Provider Directory

Locations

6600 France Ave S
Ste 635
Edina, MN 55435
Phone (612) 327-9200

2000 Plymouth Rd
Ste 110
Minnetonka, MN 55305
Phone (952) 920-4333

305 Cedar St
Ste 101
Monticello, MN 55362
Phone (763) 295-3100

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1390780800000",
    "number": "1881815322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6600 FRANCE AVE S",
            "address_2": "SUITE 615",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554351807",
            "telephone_number": "952-920-4333",
            "fax_number": "952-920-6338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6600 FRANCE AVE S",
            "address_2": "SUITE 615",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554351807",
            "telephone_number": "952-920-4333",
            "fax_number": "952-920-6338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK C ENGASSER M D P A",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-01",
        "last_updated": "2014-01-27",
        "status": "A",
        "authorized_official_last_name": "ENGASSER",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "952-920-4333",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "MN",
            "license": "22841",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "856500700",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edina, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.